HomeMy WebLinkAboutHomestead_Hallbeck�
�,. a.,,
a.i � CLAIM FOR HOMESTEAD PROP FORM YEAR
�a�;1 CREDITlSTANDARD DEDUCTION � HCio �
�„� J Slate Form Sa73 (R2 / 5-92)
��.� ��
INSTRUCTIONS: See reverse side lar7iling insrructions.
CERTIFICATION STATEMENT
I1�We) � J�iYLA �114 � a` 1 � ceriify that on the 7 st day of March. 19_
��) occupied as our principal piace o res�i—" aence the o owing described real pwperty f r which a Homesiead Property Tax Credit is hereby clalmed: I
I(We) owned ❑ Are buying under contract
.Have a beneficial interes� in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contrac�.
CONTRACT RECORDED
II buying on contran. Fee Simple owner's name
Recorder's o9�ce where mnvact is �ecorded Recortl number Page
PROPERTY DESCRIPTION
Counry � TownShip � Ta.inq distnct (cily. Iown.:ownship)
Pa¢el number (�/ ;S O!7� � Leqal descnption
I: any pOrtion of the resiaential slrucNre or ihe IaM not eyceetling one (i) acre Ihat immetliatety surrountls that strucNre is usetl to produce inCOme. describe the use and ponion
ot fie property u�ilized ro pratluce income.
�. a. 7- l9- 9S
- �14,3 . �/ 3 -
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTtAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately I I I
surroundingresidentialimprovemerns. (�)
Otherland (p)
Tota� land (line 1 plus line Z� I(3) I I
Dwelling (a)
Residenfial improvemems
Garage (5) I (
Other improvements (6)
Total impmvemenis (Ilne 4 thiough lina 6) (7) I I I
Toial value (line 3 pf�s line 7� (g) I I I
I hereby certify Ihe above is Irue. CorBC�. and Signawre of Assessor I Date slgned
complete.
�ying action � Signa;ure ot Audimr I Date s9ned
L
of Autlilor
_
19 Pay 19 _
Lesser of 1l2 Homestead
Valuation or 52.000
STANDARD DEDUCTION
Date